Tempus Fugit

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   May 26

Mental State Examination

The MSE should be in the back of one’s mind when performing a Psychiatric History taking exercise.

Note: the MSE should be made up of observations and answers given during the history taking exercise – not based on the history of the patient etc.

The Mental State Examination Consists of:

  • Appearance
  • Are they dishevelled (may indicate depression, schizophrenia etc) or brightly dressed in outrageous clothes (poor taste in clothes or potentially manic).

    Are they clean shaven? Clean? Dressed? Smell?

  • Behaviour
  • What is the behaviour of the patient during the interview? Do they make eye-contact? Are the shifty? Do they look agitated or afraid? Is their behaviour appropriate for the interview?
    Are there any mannerisms? Is there a problem with their gait?

  • Conversation (Speech)
  • Is their speech at a normal pitch and speed? Is their speech comprehensible? Is it pressured? Loud? Mumbled?

  • Affect (Mood)
  • Affect is what you describe
    Is it restricted? Blunted? Labile? Euthymic?

    Mood is what they describe
    Are they anxious? Depressed? Irritable? Cheerful?

  • Perception (Thought)
    • Thought Form
    • That is…flight of ideas, derailment

    • Thought Content
    • Are there delusions? Are they suicidal?

    • Perception
    • Are there any hallucinations, illusions (eg visual, auditory, gustatory, tactile)

  • Cognition
  • Are they orientated to time place and person?

  • Insight
  • Are they aware that they have an illness?

  • Judgement
  • Do they show appropriate judgement when asked?

  • Rapport
  • Do they develop a rapport with the interviewer? Are they withdrawn?

  • Memory
  • Is their short and long term memory in tact?

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